The black experience of cancer, relative to whites in the U.S., can be simply characterized as higher incidence, lower survival, and higher mortality. In response to the growing concerns about cancer in the New York City black community, the Harlem Hospital Center (HHC) of the New York City Health and Hospitals Corporation, in collaboration with Memorial Sloan-Kettering Cancer Center (MSKCC), propose to implement and evaluate the feasibility of an Emergency Room Cancer Screening Program (ERCSP) model, implemented within Harlem Hospital designed to increase the number of blacks screened for cancer for the first time. The collaboration between HHC and MSKCC provides a strong combination of complementary institutional strengths. Harlem Hospital will provide the overall clinical leadership, and the community hospital base to gain access to the population. MSKCC will provide its expertise in cancer control research, and cancer communications/minority health education. The specific aims of the proposed 3-year, Phase II cancer control study are to implement and evaluate a cancer control intervention designed to: 1) expand the availability and utilization of cancer screening services for a low income black population who use the hospital Emergency Room as a source of primary care, and 2) increase early detection behavior among this population. Harlem Hospital, in collaboration with MSKCC, proposes to: 1) Implement a needs assessment survey of Harlem Hospital Emergency Room patients and their accompanying friends and family to determine the best means to implement and evaluate the Emergency Room Cancer Screening Program (ERCSP); 2) Implement the ERCSP intervention in the Harlem Hospital Emergency Room to increase the availability and utilization of cancer screening services to detect cancers of the breast, cervix, and colon/rectum at an early stage of development; and 3) Design, implement and monitor a microcomputer-based data base management system for the ERCSP, in order to evaluate program utilization, reasons for refusal, clinical outcomes, and cost.